Hello and welcome to the first episode within our series on pediatric podiatry. This series will talk about some commonly seen foot and ankle injuries in children and today’s episode we’ll talk about pediatric heel pain.
One of the most commonly seen foot and ankle injuries in children is a condition called Sever’s Disease or Calcaneal Apophysitis. Calcaneal Apophysitis refers to inflammation of the growth plate at the back of the heel. This often happens during a period of growth where your child’s long bones might be growing quickly and the supporting muscles struggle to keep up with that period of growth. Then those muscles will pull on the growth plate at the back of the heel and this causes inflammation and pain.
Sever’s Disease happens more frequently in children that play sports that involve a lot of jumping. So sports like netball, basketball and football, where your child might be jumping on hard surfaces are much more likely to develop Sever’s Disease. The condition itself happens between the ages of 10 and 16, as I mentioned before, it usually happens during a period of growth. So while your child might be growing, they’re much more likely to develop Sever’s Disease and the condition itself is twice as more likely to affect boys than girls.
One of the symptoms of Sever’s Disease is pain that’s worse with exercise. So we’ll often see children getting worse as they play their sport and they’ll need to come off the ground and actually sit out for a little while to allow the pain to settle down. The pain can also lead to limping and you may notice that your child is noticing pain in one or both feet. The way it’s diagnosed in the clinic is by our calcaneal squeeze test, which is a diagnostic test that we perform here. And that involves squeezing the calcaneus, or heel bone between two hands and looking for a positive result, which would lead us to the diagnosis of Sever’s Disease.
So the treatment process starts by performing a thorough pediatric lower limb assessment. The initial phase of that will be taking a thorough history and then checking range of motion in your child’s foot, ankle and lower limb. This will then lead on to a visual gait analysis where we’ll observe your child walking and look for any abnormalities in foot posture or lower limb positioning. And in some cases, we look at any tight muscles and address this with a specific stretching plan. This then can lead on to prescribing heel lifts to take the pressure off this growth plate, rest and ice is always recommended to try and settle things down. On some occasions we may look to reduce exercise levels in the short term until we can gradually return your child back to playing sport. And in some cases we also look at orthotics to address any issues with foot posture or lower limb positioning.
Quite often when we see this condition, it’s been palmed off as growing pains but any sort of foot and ankle pain is not normal in children. You may be finding that your child is not able to keep up with other children or participate in the sports that they enjoy and that could be affecting their daily life so it’s important to have that addressed. The information in this video is general. We do recommend if your child’s experiencing any sort of foot or ankle pain that you make an appointment and this can be done through our website.
